Cannabis as a Treatment for Opioid Addiction

Is
trading opioids for cannabis a deal with the devil? Does it mean
flipping from frying pan to fire? If there’s a chance that treatment
with cannabis derivatives can help the opioid addicted it is certainly
worth consideration.

In a May 14, 2014 presentation for the National Institute of Drug Abuse, Nora D. Volkow, M.D. spoke
at length on the abuse of opioids, i.e., heroin, morphine, and
prescription pain relievers before Senate Caucus on International
Narcotics Control.

Recognizing
the gift of relief opiates provide the suffering, despite the
multiplying results of the pandemic spread in opioid dependence, she sought “scientific
insight must strike the right balance between providing maximum relief
from suffering while minimizing associated risks and adverse effects.”

Focusing
on hydrocodone and oxycodone, she reported an 100% increase in
prescriptions for hydrocodone and 81% increase for oxycodone between
1991 and 2013. And, of course, the increase in use precedes an increase
in overdoses, deaths, and healthcare costs. Speaking for scientists like
herself, she points out,
“Scientists debate the appropriateness of chronic opioid use for these
conditions [chronic back pain and osteoarthritis] in light of the fact
that long-term studies demonstrating that the benefits outweigh the
risks have not been conducted.”

Prescription
opioids attach to protein opioid receptors, found on the nerve cells of
the brain, spinal cord, and other organs of the body. The attachment
reduces the perception of pain and produces a sense of well-being.

In
addition, when repeatedly used, they induce a level of tolerance which
requires an increased dose to produce the same effect of well-being.
This leads to continued use, dependency, and overdose. Finally, the
continued use of opioids desensitizes the receptors so that the
individual feels withdrawal symptoms if the need cannot be satisfied.

Where cannabis fits in

In an interview with the Boston Herald,
Gary Witman, M.D. of Canna Care Docs reported treating 80
opioid-addicted patients with medical marijuana and saw more than 75% of
them stopped taking the harder drugs.

In the same interview, Harold Altvater, M.D. of
Delta Medical Consulting says, “You are basically taking something that
can be very harmful for an individual, and substituting with another
chemical, just like you would any other drug, that has a wider safety
margin … So if the goal is to decrease the body count … the goal would
be to get them on to a chemical that was safer.”

These
professionals are all from Massachusetts, one of the states in which
opioid addiction and deaths have reached epidemic levels. And, there are
others who fear this is only replacing one gateway drug with another.

Neurologically,
chemical compounds in cannabis map over to the brain’s endocannabinoid
system. They attach to receptions involved with appetite, memory, mood,
and pain sensation. This performance imitates that of opioids’
interaction with their receptors.

As
the brain works, dopamine motivates you to meet your needs. Once a need
has been met, the brain’s nucleus accumbens center in the hypothalamus
triggers serotonin. Serotonin leads to feelings of happiness and
well-being which, in turn, inhibits the motivation of dopamine.

When
serotonin is low, dopamine is high, making you hungry and needy.
Emotional and physical stress lower serotonin, so depression and anxiety
increase. Anything that balances the serotonin/dopamine levels can be
addictive. Opioids serve to strike that neuro-chemical balance, and so
can become addictive, especially because with frequent use they alter
serotonin receptors. There is no evidence that, barring other addictive
factors, cannabis creates the same addictive damage.

A study by 11 researchers in the Department of Psychiatry at Columbia University (September 2015),
“took a group of 60 patients dependent on opiates and placed them in a
clinic to detoxify. 32 percent of the patients were given 30 milligrams
daily of dronabinol — a form of THC — during treatment, and was found to
drastically reduce the severity of withdrawal, and patients were more
likely to complete the 8-week program.”

As reported by Oscar Pascual in SFGate,
the study also indicated, “A further analysis showed that the
percentage of patients who smoked cannabis regularly during the
outpatient phase also showed significantly lower ratings of bad health
symptoms as well.”

You
see, because cannabis reduces the perception of pain that drove people
to opioids in the first place it becomes an alternative treatment. But,
because it also treats the withdrawal symptoms like nausea, vomiting,
tremors, and muscle spasms, it is a palliative during withdrawal. And,
because cannabis use is a holistic experience inducing uplift and
happiness while reducing stress and depression, it becomes a long term
to returning to addictive behaviors.

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